Ovestin 1 mg Cream

Ovestin is a hormone replacement therapy (HRT).

Can I buy Ovestin online?

The Online Clinic can prescribe Ovestin following a consultation with one of our doctors. The consultation forms can be completed in your own time and will be reviewed by one of our GPs.

What is Ovestin?

Ovestin is used by women requiring HRT. This medicine is a cream containing an active natural female sex hormone called estriol, which acts locally within the vagina. The cream may not work immediately and improvement may take a few days or weeks. Ovestin can be used to relieve vaginal symptoms resulting from a lack of oestrogen, and both before and after surgery of the vagina to encourage wound healing.

Oestrogens are naturally produced by the ovaries to regulate development of the female reproductive system and the menstrual cycle. As a woman ages, she experiences the menopause when her ovaries slowly produce less and less oestrogen. Surgical removal of the ovaries will suddenly stop the production of oestrogen. A lack of oestrogens can affect the vagina wall, causing thinning and dryness, which can result in painful sexual intercourse and vaginal infections. The estriol in Ovestin can therefore be used to replace the oestrogen shortage.

How to use Ovestin

Ovestin can be started immediately if you have never previously used HRT, are switching from an HRT where you do not have menstrual periods, or your ovaries or womb (uterus) have been removed. Start Ovestin a week after stopping the previous HRT if making a switch from an HRT that features menstrual bleeds. Only stop using Ovestin when the doctor tells you to or your symptoms may return. In a case where you need surgery, speak to the doctor about whether it is necessary to stop and restart this medicine and, if so, when you should do this.

Ovestin cream comes with a plastic applicator, which is used to measure the dose and apply the cream to the vagina. The dose (0.5 mg estriol per 0.5 g cream) is usually one applicator full to the red ring. For vaginal difficulties, use one dose of cream per day for the first two to three weeks; then one dose twice weekly. Every few months, you may be asked to stop Ovestin for a month to assess whether you continue to need treatment. With vaginal surgery, use one dose of Ovestin per day for two weeks before surgery; then wait two or more weeks after the operation before using one dose of cream twice weekly. It is preferable to apply the cream at bedtime.

To use Ovestin, measure the correct dose by filling the applicator to the ring with cream. Firstly, remove the tube cap and pierce the tube using the sharp point on the cap. Screw the applicator onto the tube. Squeezing the tube, fill the applicator to the red ring with cream; the applicator plunger should stop at the ring. The applicator is then unscrewed from the tube and the tube cap replaced. The cream can then be applied. Once lying down, insert the applicator far into your vagina and push the plunger slowly and completely into the applicator. Remove the applicator from your vagina and pull its plunger out. Wash both plunger and applicator in hot soapy water and rinse thoroughly.

Using too much should not be a problem but tell your doctor. Any missed dose can be applied soon after you remember, but not if later than 12 hours or more.

Who can use Ovestin?

Ovestin is for women. It is not for women who are (or become) pregnant or breastfeeding. All women will need to discuss their and their family's medical history with their doctor and will likely be examined before taking Ovestin. Once started, check-ups should be regular, including self-breast examinations, breast screening, and cervical smears. The Online Clinic will only prescribe Ovestin if you have been initiated on this medication by your doctor. We provide a more convenient method of getting your prescription.

Ovestin must not be used in the following circumstances: you are hypersensitive to any of the cream's ingredients (e.g., stearyl alcohol); have previously had a heart attack, angina, blood clot, cancer of the breast or sex organs, or unexplained vaginal bleeding; or if you have too much endometrial (womb lining) thickening, porphyria, or liver disease. The doctor will want to know if you have fibroids or endometriosis, cardiovascular disease, asthma, severe headaches or migraine, diabetes, epilepsy, liver/kidney problems, gallstones, systemic lupus erythematosus, or otosclerosis (a hearing problem).

All medications that you are taking or have taken recently must be mentioned to your doctor in case they interfere with each other's action. These particularly include medicines taken for infections (viral, bacterial and fungal) or epilepsy, corticosteroids, theophylline, succinylcholine, or herbal preparations with St John's wort.

Ovestin side effects

Inform your doctor immediately about any of the following effects as you may have to stop treatment completely: raised blood pressure, migraine, signs associated with blood clots (breathlessness, chest pain, or you collapse) or jaundice (yellowish skin or whites of eyes), and any condition that stops you using the medicine (see above). Also tell your doctor about these effects as you may need to temporarily stop treatment: itchy skin around or in the vagina when treatment begins that usually disappears after a while; skin rash or photosensitivity; vaginal discharge, bleeds or spotting; tender or swollen breasts; headaches; nausea and vomiting; gall bladder problems; or flu-like symptoms.

As with all HRT, using Ovestin slightly increases your risk of breast, endometrial, and ovarian cancer; and heart disease, stroke and blood clots. Your stroke risk rises with age, high blood pressure, heart irregularities, smoking, and excess alcohol consumption. Women who are overweight or unable to move about for an extended period; or have problems with blood clotting, previously had a blood clot, a family history of blood clots or a miscarriage, are more prone to blood clots. Ovestin will not prevent you from memory loss, but previous HRT use may increase your dementia risk if it was begun after 65 years of age.

Because Ovestin is applied topically, it is less likely to cause side effects than oral HRT medicines.